Risk Markers of Juvenile Idiopathic Arthritis-associated Uveitis in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry

• Type of Material: Article
• Authors: Sheila Angeles-Han, Emory University; Christina F. Pelajo, Emory University; Larry Vogler, Emory University; Kelly Rouster Stevens, Childrens Healthcare Atlanta; Christine Kennedy, Childrens Healthcare Atlanta; Lori Ponder, Emory University; Courtney McCracken, Emory University; Jorge Lopez-Benitez, Emory University; Carolyn Drews-Botsch, Emory University; Sampath Prahalad
• Language: English
• Date: 2013-12-01
• Publisher: Journal of Rheumatology
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: The Journal of Rheumatology Copyright © 2013. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.3899/jrheum.130302
• Title of Journal or Parent Work: Journal of Rheumatology
• ISSN: 0315-162X
• Volume: 40
• Issue: 12
• Start Page: 2088
• End Page: 2096
• Grant/Funding Information: Dr. Prahalad is supported by The National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01-AR060893), The Marcus Foundation Inc. and The Arthritis Foundation.; Dr. Angeles-Han was supported by Award Number K23EY021760 from the National Eye Institute and also by a grant from the American College of Rheumatology Research and Education Foundation and the Arthritis Foundation Career Development Bridge Funding Award.; The work was done with the support of NIH funding through CARRA.
• Keywords: CLASSIFICATION; VISUAL OUTCOMES; OPHTHALMOLOGIC EXAMINATIONS; COMPLICATIONS; PREVALENCE; Science & Technology; QUALITY-OF-LIFE; Rheumatology; RISK MARKERS; Life Sciences & Biomedicine; ACUTE ANTERIOR UVEITIS; UVEITIS; OUTCOMES; FACES PAIN SCALE; GUIDELINES; JUVENILE IDIOPATHIC ARTHRITIS; CHILDREN
• Research Categories: Health Sciences, Public Health; Health Sciences, Medicine and Surgery

Abstract

Objective: To characterize the epidemiology and clinical course of children with juvenile idiopathic arthritis-associated uveitis (JIA-U) in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry and explore differences between African American (AA) and non-Hispanic white (NHW) children. Methods: There were 4983 children with JIA enrolled in the CARRA Registry. Of those, 3967 NHW and AA children were included in this study. Demographic and disease-related data were collected from diagnosis to enrollment. Children with JIA were compared to those with JIA-U. Children with JIA-U were also compared by race. Results: There were 459/3967 children (11.6%) with JIA-U in our cohort with a mean age (SD) of 11.4 years (± 4.5) at enrollment. Compared to children with JIA, they were younger at arthritis onset, more likely to be female, had < 5 joints involved, had oligoarticular JIA, and were antinuclear antibody (ANA)-positive, rheumatoid factor (RF)-negative, and anticitrullinated protein antibody-negative. Predictors of uveitis development included female sex, early age of arthritis onset, and oligoarticular JIA. Polyarticular RF-positive JIA subtype was protective. Nearly 3% of children with JIA-U were AA. However, of the 220 AA children with JIA, 6% had uveitis; in contrast, 12% of the 3721 NHW children with JIA had uveitis. Conclusion: In the CARRA registry, the prevalence of JIA-U in AA and NHW children is 11.6%. We confirmed known uveitis risk markers (ANA positivity, younger age at arthritis onset, and oligoarticular JIA). We describe a decreased likelihood of uveitis in AA children and recommend further exploration of race as a risk factor in a larger population of AA children.